oregon board of dentistry · 12/14/2012 · franklin, pediatric dentist; steven e. timm, d.m.d.,...

PUBLIC PACKET

Oregon Board Of

Dentistry

Board Meeting December 14, 2012

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29th Annual State Agency Toy Drive!

Its once again time for the Annual State Toy Drive! Every year all state agencies have the opportunity to help make the Holidays Happy for needy children throughout the State and this year seems like it may be an especially hard one for many families. If you would like to participate, please bring a new, unwrapped present of your choice with you to the December 14th Board Meeting. A box will be available in the OBD lobby for any

donation you wish to make. Items are needed for infants through 12 years. Please dont think you have to limit your

items to toys either, educational items as well as clothing are happily accepted. If you dont have time to go shopping but would still like to contribute, you can write a check payable to The Salvation Army. Any funds donated will be used to purchase toys that go directly to the Salvation Armys Toy for Joy Program. Receipts will be available upon request. If you have any questions feel free to give me a call!

Thanks! Lisa Warwick Office Specialist Oregon Board of Dentistry A few important requests: Please do not wrap the gifts. Videos must be rated "G". Gifts for ages 0 through 12 years old are needed. No toy guns! Please remember to include batteries when donating a battery-operated gift. Rather than purchase one very expensive gift, purchase several less expensive gifts. Suggested price range for each gift is $5-$20.

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Approval of Minutes

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October 5, 2012 Board Meeting Page 1 of 11

OREGON BOARD OF DENTISTRY MINUTES

October 5, 2012

MEMBERS PRESENT: Patricia Parker, D.M.D., President

Jonna E. Hongo, D.M.D., Vice-President Brandon Schwindt, D.M.D. Alton Harvey, Sr. Julie Ann Smith, D.D.S., M.D. Darren Huddleston, D.M.D. Jill Mason, M.P.H., R.D.H. Norman Magnuson, D.D.S. Mary Davidson, M.P.H., R.D.H.

STAFF PRESENT: Patrick D. Braatz, Executive Director

Paul Kleinstub, D.D.S., M.S., Dental Director/Chief Investigator Daryll Ross, Investigator (portion of meeting) Harvey Wayson, Investigator (portion of meeting) Michelle Lawrence, D.M.D., Consultant (portion of meeting) Rodney Nichols, D.D.S., Consultant (portion of meeting) Lisa Warwick, Office Specialist (portion of meeting) Stephen Prisby, Office Manager (portion of meeting)

ALSO PRESENT: Lori Lindley, Sr. Assistant Attorney General VISITORS PRESENT: Sheri Billetter, ODAA; Beryl Fletcher, ODA; Dana Shipley, R.D.H.,

ODHA; Lisa Rowley, R.D.H., Pacific University; Judd Larson, D.D.S., ODA; Bill Saiget, D.D.S., Interdent; Patricia Peirano Franklin, Pediatric Dentist; Steven E. Timm, D.M.D., ODA; Pamela Lynch, R.D.H., ODHA

Call to Order: The meeting was called to order by the President at 7:30 a.m. at the Board office; 1600 SW 4th Ave., Suite 770, Portland, Oregon. NEW BUSINESS MINUTES Dr. Magnuson moved and Ms. Mason seconded that the minutes of the August 3, 2012 Board meeting be approved as amended. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. ASSOCIATION REPORTS Oregon Dental Association Dr. Larson stated that the Oregon Mission of Mercy saw over 1200 patients and provided $750,000 worth of dental work. He also took the opportunity to introduce Dr. Steven Timm as the new ODA Vice-President.


Oregon Dental Hygienists Association Ms. Shipley invited everyone to the ODHAs Fall Dental Health Conference, being held October 26 - 28. She also thanked Teresa Haynes and Paul Kleinstub for presenting at the conference in advance. Oregon Dental Assistants Association Sheri Billetter stated that the ODAA will be having their association meeting as part of the ODHAs Fall Dental Health Conference on Oct. 27th and added that Ms. Fletcher of the ODA will be presenting at the meeting on the topic of best management practices and how they impact staff. COMMITTEE AND LIAISON REPORTS WREB Liaison Report Dr. Magnuson stated that there will be a strategic planning meeting in November and that the minutes from the last Board meeting were in the Board handout. AADB Liaison Report Dr. Parker stated that the ADA and AADB meetings would be occurring soon and that there will be a full report at the December Board meeting. Mr. Braatz stated that there will be a discussion regarding Botulinum toxin type A at the meeting. He stated that there is a 50 page report, which would be made available to the Board shortly, with the most current state standings on the matter. ADEX Liaison Report Dr. Parker had nothing new to report and that the next ADEX meeting would take place in November. NERB Dr. Hongo had nothing to report. Licensing, Standards and Competency Committee Meeting Report Dr. Magnuson stated that the Licensing, Standards and Competency Committee meeting was rather long and that ultimately the committee decided that general dentists with appropriate training, were within their scope of practice to be allowed to use Botulinum toxin type A with dental justification. He stated that a motion was made and passed to send this to the Rules Oversight Committee for development of more specific rules. Dr. Schwindt clarified with Dr. Magnuson that dermal fillers were not part of the Botulinum toxin type A decision. Dr. Magnuson also stated that the Committee had decided to leave the current CE requirements as they were. Committee Meeting Dates Mr. Braatz stated that he and Dr. Schwindt were working on planning a Rules Oversight Committee meeting and that more information would be available soon. EXECUTIVE DIRECTORS REPORT Budget Status Report Mr. Braatz stated that the budget was performing as expected and that hes been watching it closely due to the current economy. He added that the latest budget report for the 2011-2013 Biennium was attached and that the report, which is from July 1, 2011 through August 31, 2012, shows revenue of $1,544,653.39 and expenditures of $1,307,398.42. Revenues continue to be on target and the expenditures are actually below what was budgeted.


OBD 2013-2015 Agency Budget Request Mr. Braatz stated that he included a copy of the 2013-2015 Agency Budget Request for the Boards review. He added that the Budget has been submitted to the Department of Administrative Services and he has not yet received a response from them. Customer Service Survey Report Mr. Braatz attached a chart which shows the OBD State Legislatively Mandated Customer Service Survey Results from July 1, 2012 through August 31, 2012. The results of the survey show that the OBD continues to receive positive comments from the majority of those that return the surveys. The booklet containing the written comments that are on the survey forms, which staff has reviewed, are available on the table for Board members to review. Mr. Braatz reported that the staff was currently receiving an 80% positive response from those surveys that are being returned to us. Board and Staff Speaking Engagements Friday, September 7th - Mr. Braatz made a presentation to the Oregon House of Delegates in Redmond, Oregon. HPSP Annual Report Mr. Braatz attached the 2nd Annual HPSP report for the Board to review. He stated that the bill for the HPSP program was $200,000.00 for just this past year and that hes not sure what it will be next year. He added that he felt there would be some changes to this program in the upcoming year due to feedback from the various boards that have been required to use this program. Agency Head Financial Transaction Report 7/1/2011-6/30/2012 Mr. Braatz presented the Agency Head Financial Transaction Report showing all his leave, Spots Card purchases, travel reimbursements and other various expenditures for the Boards review. Dr. Huddleston moved and Ms. Davidson seconded that the Board approve the Agency Head Financial Transaction Report as presented. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Legislative Report on the Reimbursement of Expanded Practice Permit Dental Hygienists Mr. Braatz stated that the Board could find their first report on the Reimbursement of Expanded Practice Permit Dental Hygienists in their books. He stated that this report covers the period from January 1, 2012 to June 30, 2012 and that the next report will have a full two years of data for the Board to review. Newsletter Mr. Braatz stated that he was still attempting to get the newsletter out for late Fall of 2012. Board Resignation Mr. Braatz stated that Mr. David Smyth has officially resigned from the Board. His term officially ended last March, yet Mr. Smyth continued in his position as public member with the Board in hopes that the Governors Office would be able to fill the position quickly. Mr. Braatz stated that it appears that this was not the case. Mr. Smyth had personal issues to attend to and felt it was time to officially resign the seat. Staff Return Mr. Braatz stated that Mr. Daryll Ross has returned to work and we are all happy to have him back.


UNFINISHED BUSINESS CORRESPONDENCE The Board received a letter from John L. Krump, D.D.S. Dr. Krump sent a letter to the Board asking them to consider a rule change regarding patient records for individuals who have received dental implants. Ms. Mason moved and Dr. Magnuson seconded that this be moved to the Rules Committee for establishment of rules as this is currently an issue for dentists. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. The Board received a letter from Louis Malcmacher, D.D.S., M.A.G.D. Dr. Malcmacher sent a letter to the Board, as well as several articles, in an attempt to show the Board that Botox and dermal fillers are well within the scope of the practice of Dentistry. The Board received a letter from Samuel A. Fleishman, M.D. Dr. Fleishman sent a letter to the Board asking for their professional opinion regarding the scope of Dentistry as it pertains to dentists and some recent advertising claims that dentists are within their scope of practice to diagnose sleep apnea by utilizing home sleep tests. The Board directed Mr. Braatz to respond with a letter stating that, The ordering, interpreting and managing of tests for sleep apnea is outside the scope of dentistry, whereas making the appliance is well within the scope of dentistry. OTHER BUSINESS Articles and News of Interest (no action necessary) Nothing Presented EXECUTIVE SESSION: The Board entered into Executive Session pursuant to ORS 192.606 (1)(f), (h) and (k); ORS 676.165; ORS 676.175 (1), and ORS 679.320 to review records exempt from public disclosure, to review confidential investigatory materials and investigatory information, and to consult with counsel. PERSONAL APPEARANCES AND COMPLIANCE ISSUES Licensees appeared pursuant to their Consent Orders in case numbers 2007-0071 and 2005-0117. LICENSING ISSUES OPEN SESSION: The Board returned to Open Session.


CONSENT AGENDA 2013-0033, 2013-0016, 2013-0024, 2013-0037, 2013-0036, 2013-0017, 2013-0045 and 2013-0012 Dr. Hongo moved and Mr. Alton seconded that the above referenced cases be closed with No Further Action or No Violation of the Dental Practice Act per the staff recommendations. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. COMPLETED CASES 2011-0169, 2012-0196, 2012-0129, 2010-0114, 2011-0171, 2013-0009, 2011-0223, 2012-0065, 2011-0232, 2010-0094, 2012-0067, 2012-0191, 2013-0013, 2013-0010, 2013-0040 and 2012-0141 Dr. Hongo moved and Dr. Magnuson seconded that the above referenced cases be closed with a finding of No Violation of the Dental Practice Act or No Further Action per the Board recommendations. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Smith recused herself on case # 2013-0009 and case # 2013-0010. Dr. Schwindt recused himself on Case # 2012-0065. ALLEMAN, ALFRED D., D.M.D. 2012-0026 Mr. Harvey moved and Ms. Mason seconded that the Board issue a Notice of Proposed Disciplinary Action and offer the Licensee a Consent Order in which the Licensee would agree to make a restitution payment in the amount of $4,659.00 to the patient. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason and Dr. Magnuson voting aye. Ms. Davidson recused herself. 2012-0054 Dr. Huddleston moved and Dr. Magnuson seconded that the Board close the matter with a STRONGLY worded Letter of Concern addressing the issue of ensuring that when informed consent is obtained prior to providing treatment, PARQ or its equivalent is documented in the patient records and that a dental diagnosis is also documented in the patients records prior to providing treatment. The motion passed with Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Hongo recused herself. DAVENPORT, RICHARD W., D.M.D. 2011-0059 Dr. Schwindt moved and Ms. Davidson seconded that the Board issue a Notice of Proposed Disciplinary Action and offer the Licensee a Consent Order in which the Licensee would agree to be reprimanded and make a restitution payment to the patient in the amount of $6,600.00. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. GRUBBS, HEIDI J., R.D.H. 2011-0044 Ms. Mason moved and Dr. Smith seconded that the Board issue a Board Order requiring Licensee to undergo a substance use disorder evaluation at a Board approved facility within 30 days of the effective date of the Order, unless the Board grants an extension and informs Licensee in writing. Licensee shall provide the Board with the evaluation reports within seven days of receipt. The evaluation(s) are to be at the Licensees expense. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. LEE, CHRIS Y.J., D.M.D. 2012-0010 Dr. Smith moved and Dr. Hongo seconded that the Board issue a Notice of Proposed Disciplinary


Action and offer the Licensee a Consent Order in which the Licensee would agree to be reprimanded, to complete at least three hours of continuing education in record keeping within six months and cease placing dental implants pending further order of the Board. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. 2010-0139 Dr. Magnuson moved and Dr. Hongo seconded that the Board close the matter with a Letter of Concern addressing the issue of ensuring that informed consent is obtained prior to providing treatment, PARQ or its equivalent is documented in the patient records and that the patient has a clear understanding of the proposed outcome of treatment. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. REGAN, MICHAEL C., D.M.D. 2010-0186 Ms. Davidson moved and Dr. Hongo seconded that the Board issue a Notice of Proposed Disciplinary Action and offer the Licensee a Consent Order incorporating a reprimand, a $5,000 civil penalty, to complete three hours of continuing education in record keeping which must be completed within six months of the effective date of the Order and to cease implant placement until successful completion of the Boards mentoring program with a focus on implant placement. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. 2012-0131 Mr. Harvey moved and Dr. Huddleston seconded that the Board close the matter with a Letter of Concern reminding the Licensee that the patient record must include the date, name of, quantity of, and strength of all drugs dispensed, administered or prescribed and a diagnosis that supports the use of such medications. The motion passed with Dr. Hongo, Mr. Harvey, Dr. Huddleston, Dr. Smith, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Schwindt recused himself. 2011-0204 Dr. Huddleston moved and Dr. Hongo seconded that the Board close the matter with a Letter of Concern addressing the issue of ensuring that the Licensee be in compliance with the requirements for maintaining the Licensees Nitrous Oxide Permit. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. PREVIOUS CASES REQUIRING BOARD ACTION COMBE, R. OWEN, D.M.D. 2005-0117 Dr. Schwindt moved and Dr. Smith seconded that the Board deny Licensees request to have a DEA registration. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. FRYE, RAYMOND L., D.M.D. 2012-0064 and 2012-0117 Dr. Smith moved and Mr. Harvey seconded that the Board accept Licensees offer of a Consent Order incorporating a reprimand, pay a $10,000 civil penalty and complete three hours of continuing education in record keeping within six months. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye.


GARCIA, PETER, D.M.D. and GARCIA, ARLENE, R.D.H. 2012-0150 Ms. Mason moved and Ms. Davidson seconded that the Board accept Licensees proposal and offer each respondent an individual Consent Order incorporating a reprimand and 50 hours of Board approved pro bono community service within 18 months, per Board protocol. The motion passed with Dr. Schwindt, Mr. Harvey, Dr. Smith, Ms. Mason, Dr. Huddleston, Dr. Magnuson and Ms. Davidson voting aye. Dr. Hongo recused herself. GARVIN, JACK G., D.M.D. 2011-0090 Dr. Magnuson moved and Dr. Smith seconded that the Board deny Licensees request and require him to retire his Oregon dental license effective 10/5/12. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. LOXLEY, EMINE C., D.M.D. 2011-0078 Ms. Davidson moved and Dr. Hongo seconded that the Board deny Licensees offer to resolve the matter, to issue a Third Amended Notice of Proposed Disciplinary Action, offer Licensee a Consent Order incorporating a reprimand and pay a $2,000 civil penalty. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. PILCHER, JAMES C., D.D.S. 2011-0013 Mr. Harvey moved and Dr. Hongo seconded that the Board accept Licensees dental license resignation in lieu of further action for his failure to follow a Board order. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Huddleston recused himself. RODRIGUEZ, ROBERT L., D.M.D. 2009-0275 Dr. Huddleston moved and Mr. Harvey seconded that the Board deny Licensees request to resolve the matter with a Letter of Concern and affirm the Boards action of 2/10/12 and require that the continuing education requirement be completed within six months. The motion passed with Dr. Hongo, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Schwindt recused himself. SMITH, LYNN E., D.M.D. 2010-0079 Dr. Schwindt moved and Dr. Hongo seconded that the Board offer Licensee an Amended Consent Order by which Licensee is released from the requirement to submit to an assessment for competency in the D-PREP program, as per his Consent Order, dated 6/17/11, providing he agrees to enter into the Boards mentoring program. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. LICENSURE AND EXAMINATION Review of Request for General Anesthesia Permit Dr. Smith brought the General Anesthesia Application of Licensee M.E. to the Board for review pursuant to OAR 818-026-0030(e). Dr. Schwindt moved and Ms. Mason seconded that Licensee M.E.s request for a General Anesthesia Permit be granted. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Smith recused herself.


Review of Request for Minimal Sedation Permit Dr. Smith brought the Minimal Sedation Application of Licensee R.M. to the Board for review pursuant to 818-026-0030(e). Dr. Magnuson moved and Ms. Mason seconded that Licensee R.M.s request for Minimal Anesthesia Permit be granted. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dr. Smith recused herself. Soft Reline Instructor Permit Dr. Huddleston moved and Ms. Mason seconded to grant Ms. Dean a Soft Reline Instructor Permit. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Ratification of Licenses Issued Ms. Davidson moved and Dr. Magnuson seconded that licenses issued be ratified as published. The motion passed with Dr. Hongo, Dr. Schwindt, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Dental Hygiene H6262 SARAH ANN GEARK, R.D.H. 7/24/2012 H6263 NICOLE LEIGH OLTS, R.D.H. 7/24/2012 H6264 KAYLA R SOTO, R.D.H. 7/24/2012 H6265 KELLY J JORDAN, R.D.H. 7/24/2012 H6266 TANIA COSTEA, R.D.H. 7/24/2012 H6267 MEREDITH LYNN ROBINSON, R.D.H. 7/24/2012 H6268 ASHLY T BARBER, R.D.H. 7/24/2012 H6269 BRITTANY BURCHATZ, R.D.H. 7/24/2012 H6270 KRISTIN L SHOEMAKER, R.D.H. 7/31/2012 H6271 BENJAMIN O SANDVICK, R.D.H. 7/31/2012 H6272 JESSICA L ROTH, R.D.H. 7/31/2012 H6273 CELESTE L PETERSON, R.D.H. 7/31/2012 H6274 MAAROF T SADIQ, R.D.H. 7/31/2012 H6275 KENDRA MICHELLE PURDY, R.D.H. 7/31/2012 H6276 REBECCA ANN BAILEY, R.D.H. 7/31/2012 H6277 MEGAN L JOHNSON, R.D.H. 7/31/2012 H6278 AMBER DAWN NICHOL, R.D.H. 7/31/2012 H6279 ASH L EDWARDS, R.D.H. 7/31/2012 H6280 ANGELA G KREMER, R.D.H. 7/31/2012 H6281 NICOLE LYNN CHAKARUN, R.D.H. 8/3/2012 H6282 MIJUNG UNVERSAGT, R.D.H. 8/3/2012 H6283 STACEY WILTERMOOD, R.D.H. 8/3/2012 H6284 NATASHA X BOYCE, R.D.H. 8/3/2012 H6285 MARIE WOURMS, R.D.H. 8/3/2012 H6286 KAWINTHRA P LUCK, R.D.H. 8/3/2012 H6287 SHELLYANN M GIBSON, R.D.H. 8/3/2012 H6288 NICOLE HURD, R.D.H. 8/3/2012 H6289 JESSICA A THOMAS, R.D.H. 8/3/2012 H6290 DESIREE A DUBISAR, R.D.H. 8/3/2012 H6291 ANNIE M HOUSTON, R.D.H. 8/3/2012


H6292 HEATHER A BESSE, R.D.H. 8/3/2012 H6293 KRISTINE SUE JENNINGS, R.D.H. 8/2/2012 H6294 RACHAEL E CURTIS, R.D.H. 8/6/2012 H6295 ALLISON M RAPHAEL, R.D.H. 8/10/2012 H6296 LAUREN A LAWLESS, R.D.H. 8/10/2012 H6297 KYLE A DENMARK, R.D.H. 8/10/2012 H6298 RENEE MORTIMORE, R.D.H. 8/10/2012 H6299 ALLISON M ALEKSIC, R.D.H. 8/10/2012 H6300 KAILI M RUTKOWSKI, R.D.H. 8/10/2012 H6301 ASHLEY M MCCLURE, R.D.H. 8/10/2012 H6302 KATHERINE ANN LIERMANN, R.D.H. 8/10/2012 H6303 CHRISTINE M BRENNAN, R.D.H. 8/16/2012 H6304 MICHELLE A VAUGHN, R.D.H. 8/16/2012 H6305 KATARZYNA TEEGARDEN, R.D.H. 8/16/2012 H6306 LE TRAN, R.D.H. 8/16/2012 H6307 INNA ANATOLYEVNA LEONCHIK, R.D.H. 8/16/2012 H6308 JOANNE ALIDA TUSTISON, R.D.H. 8/16/2012 H6309 JENNIFER A LONG, R.D.H. 8/16/2012 H6310 DANIELLE LYNN CHAKARUN, R.D.H. 8/16/2012 H6311 CHELSEA L BAKER, R.D.H. 8/16/2012 H6312 FRANCIS VEGERANO, R.D.H. 8/16/2012 H6313 TALISA E TAYLOR, R.D.H. 8/16/2012 H6314 ANDREA M WILKIE, R.D.H. 8/16/2012 H6315 KELDA ALILLIAN FRAZIER, R.D.H. 8/21/2012 H6316 JULIE A GRAGG, R.D.H. 8/21/2012 H6317 BRITTANY L PAYNE, R.D.H. 8/21/2012 H6318 ALISHA A ORR, R.D.H. 8/21/2012 H6319 ALYSSA K GARNER, R.D.H. 8/21/2012 H6320 CHRISTIANNA E REANEY, R.D.H. 8/21/2012 H6321 JENNIFER N FOUSE, R.D.H. 8/21/2012 H6322 MASA S YOUNGBLOOD, R.D.H. 8/21/2012 H6323 DOMENICA M MC LAUGHLIN, R.D.H. 8/21/2012 H6324 KARA KLOPFENSTEIN, R.D.H. 8/21/2012 H6325 KIMBERLY A QUEST, R.D.H. 8/21/2012 H6326 JEANETTE PEREZ-VOGT, R.D.H. 8/21/2012 H6327 MICHELLE C RADULESCU, R.D.H. 8/23/2012 H6328 HA T BUI, R.D.H. 8/23/2012 H6329 AMBER SELKOW, R.D.H. 8/23/2012 H6330 TAMMY GREVE-EGAN, R.D.H. 8/23/2012 H6331 SHEENA LYNN BATEMAN, R.D.H. 8/24/2012 H6332 JOHN E GARNACHE, R.D.H. 8/28/2012 H6333 AIMEE R ELROD, R.D.H. 8/28/2012 H6334 FAREN G CALDWELL, R.D.H. 8/28/2012 H6335 CHELSEY A VANDEWALL, R.D.H. 8/28/2012 H6336 AMANDA E BOLLIGER, R.D.H. 8/28/2012 H6337 HOLLY A ARNOLD, R.D.H. 8/28/2012 H6338 FOZIA A MOHAMED, R.D.H. 8/28/2012 H6339 KIM SUZANN VIAN, R.D.H. 8/28/2012 H6340 LISA A SOLTANI, R.D.H. 9/13/2012 H6341 DANYELL G BROOKBANK, R.D.H. 9/13/2012 H6342 AMANDA J HIGNELL, R.D.H. 9/13/2012


H6343 KYLIE N ANTOLINI, R.D.H. 9/13/2012 H6344 CHANTELLE S MOLLERS, R.D.H. 9/13/2012 H6345 KELSEY M FENSTEMACHER, R.D.H. 9/13/2012 H6346 ANNA M KOROTEYEV, R.D.H. 9/13/2012 H6347 AMANDA L LANGENHUYSEN, R.D.H. 9/13/2012 H6348 ELIZA M BROEHL, R.D.H. 9/13/2012 H6349 MEAGAN A LIPTAK, R.D.H. 9/13/2012 H6350 JONNIE L MC BRIDE, R.D.H. 9/13/2012 H6351 THUY TRAN-CHU, R.D.H. 9/13/2012 H6352 ALBINA P BURUNOVA, R.D.H. 9/13/2012 H6353 NICHOLE DAVIDSON, R.D.H. 9/13/2012 H6354 KAREN A WATERS, R.D.H. 9/13/2012 H6355 AMANDA K BLACK, R.D.H. 9/20/2012 H6356 KIMBERLY M HIDAY, R.D.H. 9/20/2012 H6357 LACEY M ULMER, R.D.H. 9/20/2012 H6358 IZUMI K HANSEN, R.D.H. 9/20/2012 H6359 ROBIN W ROSS, R.D.H. 9/20/2012 H6360 TANIA CAROLINA ROJERO SANCHEZ, R.D.H. 9/20/2012 H6361 DAINA A COULSON, R.D.H. 9/20/2012 H6362 MELISSA SMITH, R.D.H. 9/20/2012 H6363 MORGAN A WELLER, R.D.H. 9/20/2012 H6364 EMILY E COOKE, R.D.H. 9/20/2012 H6365 JESSICA J BARTON, R.D.H. 9/20/2012 H6366 ANNA M SHERIDAN, R.D.H. 9/21/2012 Dentists D9754 ANNE ADAMS-BELUSKO, D.M.D. 7/20/2012 D9755 JORDAN R TAKAKI, D.M.D. 7/20/2012 D9756 THERESA M COLLINS, D.M.D. 7/20/2012 D9757 KATHRYN ANNE ZOUMBOUKOS, D.M.D. 7/20/2012 D9758 MICHAEL JOHN SPARROW, D.M.D. 7/20/2012 D9759 BRANDON S REHRER, D.D.S. 7/20/2012 D9760 NATASHA M BRAMLEY, D.M.D. 7/24/2012 D9761 DEEPAK DEVARAJAN, D.M.D. 7/24/2012 D9762 EVON T HEASER, D.D.S. 7/31/2012 D9763 STEVEN R SCHMID, D.D.S. 7/31/2012 D9764 CHADWICK D TRAMMELL, D.D.S. 7/31/2012 D9765 RYAN LAYNE REESE, D.M.D. 7/31/2012 D9766 DIANA V BOKOV, D.M.D. 7/31/2012 D9767 JAMES E RUCKMAN, D.M.D. 8/3/2012 D9768 PAUL MICHAEL THORESON BUCK, D.D.S. 8/3/2012 D9769 STEPHEN GEORGE, D.M.D. 8/3/2012 D9770 RICHARD ANDREW ZELLER, D.D.S. 8/3/2012 D9771 JED TAUCHER, D.M.D. 8/3/2012 D9772 THEODORE R RASK, D.M.D. 8/3/2012 D9773 CURTIS A PETERS, D.M.D. 8/10/2012 D9774 SONJA ANN SPROUL, D.D.S. 8/10/2012 D9775 HYUNG MIN C CHA, D.M.D. 8/10/2012 D9776 AARON POGUE, D.M.D. 8/10/2012 D9777 TRISTAN J STONE, D.D.S. 8/16/2012 D9778 GARY MENCL, D.M.D. 8/21/2012


D9779 AARON J RINTA, D.M.D. 8/23/2012 D9780 CAROLYN S CHOI, D.M.D. 8/23/2012 D9781 CHEN CHEN JANE XING, D.M.D. 8/23/2012 D9782 RICHARD M LUBOW, D.M.D. 8/28/2012 D9783 CAROLINE M MAY, D.D.S. 8/28/2012 D9784 RAJESH CHUNDURI, D.M.D. 8/28/2012 D9785 RACHEL M DEININGER, D.D.S. 9/13/2012 D9786 WENLANG ZHANG, D.D.S. 9/13/2012 D9787 ANTON JON CONKLIN, D.M.D. 9/13/2012 D9788 PAUL D HARDMAN, D.M.D. 9/13/2012 D9789 HIRAL SHAH, D.M.D. 9/13/2012 D9790 ROSS U ICYDA, D.M.D. 9/13/2012 D9791 KEVIN J FORD, D.M.D. 9/13/2012 D9792 DEMIAN SCOTT WOYCIEHOWSKY, D.M.D. 9/13/2012 D9793 AMIR F AZARISAMANI, D.M.D. 9/20/2012 D9794 KRISTA A LOWEN, D.D.S. 9/21/2012 DF0025 JAMES A KATANCIK, D.D.S. 9/13/2012 Announcement No announcements ADJOURNMENT The meeting was adjourned at 12:02 p.m. Dr. Parker stated that the next Board meeting would take place December 14, 2012. Approved by the Board December 14, 2012.

___________________________________ Patricia Parker, D.M.D. President

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November 2, 2012 Special Telephone Conference Board Meeting Page 1 of 1

OREGON BOARD OF DENTISTRY SPECIAL TELEPHONE CONFERENCE MINUTES

November 2, 2012

MEMBERS PRESENT: Patricia Parker, D.M.D., President

Jonna E. Hongo, D.M.D., Vice-President Alton Harvey, Sr. Julie Ann Smith, D.D.S., M.D. Darren Huddleston, D.M.D. Jill Mason, M.P.H., R.D.H. Norman Magnuson, D.D.S. Mary Davidson, M.P.H., R.D.H.

STAFF PRESENT: Patrick D. Braatz, Executive Director

Paul Kleinstub, D.D.S., M.S., Dental Director/Chief Investigator Harvey Wayson, Investigator Stephen Prisby, Office Manager

ALSO PRESENT: Lori Lindley, Sr. Assistant Attorney General Call to Order: The meeting was called to order by the President at 12:00 p.m. at the Board office; 1600 SW 4th Ave., Suite 770, Portland, Oregon. Board Members and Board Counsel were present via telephone. EXECUTIVE SESSION: The Board entered into Executive Session pursuant to ORS 192.606 (1)(f), (h) and (k); ORS 676.165; ORS 676.175 (1), and ORS 679.320 to review records exempt from public disclosure, to review confidential investigatory materials and investigatory information, and to consult with counsel. OPEN SESSION: The Board returned to Open Session. HUSER, SHELLY R., R.D.H. 2009-0105 Mr. Harvey moved and Dr. Smith seconded that the Board issue an Order of Immediate Emergency License Suspension, suspending Licensees Oregon dental hygiene license, pending further order of the Board and deny Licensees request for the consideration of a third evaluation. The motion passed with Dr. Hongo, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. Mr. Harvey moved and Dr. Magnuson seconded that the Board grant Mr. Braatz the authority to sign the Order immediately. The motion passed with Dr. Hongo, Mr. Harvey, Dr. Smith, Dr. Huddleston, Ms. Mason, Dr. Magnuson and Ms. Davidson voting aye. ADJOURNMENT The meeting was adjourned at 12:20 p.m. Approved by the Board December 14, 2012. ___________________________________ Patricia Parker, D.M.D. President

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ASSOCIATION REPORTS

Nothing to report under this tab

committee reports

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American Board of Dental Examiners, Inc. a test development agency for the member state dental boards

2011-2012 Annual Report

Contents

Message from the President 1

ADEX Membership 2

ADEX Governance 4

ADEX Committees 10

ADEX Dental Licensing Examination 16

ADEX Dental Hygiene Licensing Examination 29

ADEX Annual Report 1

Message from the President Welcome to the Eighth Annual ADEX House of Representatives. The American board of Dental Examiners (ADEX) has just finished its seventh full year of initial licensure examinations in dentistry and dental hygiene. This has been an especially busy year with much accomplished. Three new states (Virginia, Mississippi and New Mexico) have become members. At the same time, we continue to strengthen our examinations with a special emphasis this year on improving our calibration exercises. ADEX still remains the largest licensure test development entity for dentistry in the United States with 30 state dental boards as members and with approximately 41 states accepting the examinations for licensure. This progress is due to the support and commitment of the member state boards and the volunteers chosen by those state dental boards toward developing the most valid, reliable and defensible examinations possible for the dental profession. Thank you for your dedication and participation in the 2012 ADEX House of Representatives.

Bruce Barrette, DDS President, ADEX


ADEX Membership

Membership gives a recognizing state dental board direct involvement in the development and evolution of the examinations through committee appointments; and approval of the final form of the examinations in dentistry and dental hygiene through their appointments to the House of Representatives. Consumer members of state dental boards are full active voting members of ADEX directly involved in the evolution and participation of the examinations.

Member Jurisdictions

Arkansas

Colorado

Connecticut

District of Columbia

Florida

Hawaii

Illinois

Indiana

Iowa

Kentucky

Maine

Maryland

Massachusetts

Michigan

Mississippi

New Mexico

Nevada

New Hampshire

New Jersey

Ohio

Oregon

Pennsylvania

Rhode Island

South Carolina

Tennessee

Wyoming

Vermont

Virginia

West Virginia

Wisconsin


ADEX Districts

ADEX initial districts were drawn to try to equalize the number of dental students, dentists licensed each year, and to some degree practicing dentist numbers. District 1: California District 2: Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming District 3: Kansas, Missouri, Nebraska, Oklahoma, Texas District 4: Iowa, Minnesota, North Dakota, South Dakota, W isconsin District 5: I ll inois, Indiana, M ichigan, Ohio District 6: Arkansas, Georgia, Kentucky, South Carolina, Tennessee, Virginia, West Virginia District 7: Maryland, Pennsylvania District 8: Connecticut, Delaware, District of Columbia, U.S. Virgin Islands District 9: New Hampshire, New Jersey, New York, Rhode Island District 10: Maine, Massachusetts, Vermont District 11: Alabama, Louisiana, M ississippi, North Carolina, Puerto Rico District 12: Florida States highlighted in bold italics are Member States


ADEX Governance Governing Principle

ADEXs governing principle is that the governing authority is vested with the active member state boards of dentistry. Representatives are directly appointed by the active state dental board and the directors elected by state board representatives. Important committee appointments are directly made through the representatives of the active state dental boards.

House of Representatives Governance is from the Member State Dental Boards in the House of Representatives.

The House of Representatives consists of dentist or executive director representatives from the member state dental boards. They hold final approval of major examination changes.

Each state board will designate one representative.

Representatives are required to have been active voting board members of the member

state at some time. A Dental Hygiene representative from each ADEX district is required to be or have been

an active board member from a member state.

A Consumer representative from each ADEX district is required to be or have been an active board member from a member state.

Each state will determine the qualifications of their representative.

Members from American Dental Association (ADA), American Student Dental

Association (ASDA), American Dental Education Association (ADEA), American Dental Hygienists Association (ADHA), The National Dental Examining Board of Canada (NDEB), Canadian Dental Association (CDA), National Board of Medical Examiners (NBME), and Federation of State Medical Boards (FSMB) are chosen by their respective organizations.


2011 ADEX House of Representatives

Dentist or Executive Director Representatives

Colorado Mr. Maulid Miskell Connecticut David Perkins, DDS District of Columbia Robert Ray, DMD Florida Wade Winker, DDS Hawaii Mark Baird, DDS Illinois Dennis Manning, DDS Indiana Matthew Miller, DDS Iowa No Representative Kentucky H.M. Bo Smith< DDS Maine Rockwell Davis, DDS Maryland Maurice Miles, DDS Massachusetts Mina Paul, DDS Michigan William Wright, DDS

Nevada William Pappas, DDS New Hampshire Neil Hiltunen, DMD New Jersey Peter DeSciscio, DDS Ohio Phil Beckwith, DDS Oregon Patricia Parker, DMD Pennsylvania John V. Reitz, DDS Rhode Island Henry Levin, DDS South Carolina Michelle Bedell, DDS Vermont Richard Dickinson, DDS West Virginia Craig Meadows, DDS Wisconsin Dr. Keith Clemence, DDS Wyoming Scott Houfek, DDS


2011 ADEX House of Representatives (cont.) Dental Hygiene Representatives

Mary Davidson, RDH, MPH, OR District 2

Nan Dreves, RDH, MBA, WI District 4

Mary Johnston, RDH, MI District 5

Dina Vaughn, BSDH, MS, WV District 6

Cheryl Bruce, RDH, MD District 7

Sibyl Gant, RDH, DC District 8

Nancy St. Pierre, RDH, NH District 9

Karen Dunn, RDH, MA District 10

Irene Stavros, RDH, FL District 12

Consumer Representatives

Marian Grey, HI District 2

Ms. Judith Ficks, WI District 4

Ms. Clance LaTurner, IN District 5

Mr. Allan D. Francis, KY District 6

Allan Horwitz, Esq., PA District 7

No Representative District 8

Ms. Lynn Joslyn, NH District 9

Ms. Diane Denk, ME District 10

Ms. Vicki Campbell, FL District 12


2011 ADEX House of Representatives (cont.)

Associate Members

American Dental Association Samuel Low, DDS, ADA Trustee

American Student Dental Association Mr. Ken Randall, President

American Dental Education Association Peter Robinson, DDS

American Dental Hygienists Association No Representative

National Dental Examining Board of Canada No Representative

Canadian Dental Association No Representative

Federation of State Medical Boards No Representative

National Board of Medical Examiners No Representative


ADEX Board of Directors ADEX Officers

Bruce Barrette, DDS Wisconsin President

Stanwood Kanna, DDS Hawaii Vice-President

William Pappas, DDS Nevada Secretary

H.M. Bo Smith, DMD Arkansas Treasurer

Guy Shampaine, DDS Maryland Immediate Past President

ADEX Board of Directors Up to 17 Members

12 Districts, Examination Committee Chairs, Dental Hygiene Representatives

Directors elected by state board representatives in House of Representatives

Board of Directors Stan Kanna, DDS Hawaii District 2

Bruce Barrette, DDS Wisconsin District 4

M.H VanderVeen, DDS Michigan District 5

Michelle Bedell, DMD South Carolina District 6

Guy Shampaine, DDS Maryland District 7

Robert Ray, DMD DC District 8

Peter DeSciscio, DMD New Jersey District 9

Richard Dickinson, DDS Maine District 10

Jeffrey Hartsog, DDS Mississippi District 11

Wade Winker, DDS Florida District 12

Ms. Judith Ficks Wisconsin Consumer Member

Mr. Zeno St. Cyr, II Maryland Consumer Member

Cathy Turbyne, EdD, MS, RDH Maine Hygiene Member

James Tuko McKernan, RDH, Nevada Hygiene Member

Nancy St. Pierre, RDH, New Hampshire Chair, Dental Hygiene Examination Committee

Scott Houfek, DDS Wyoming Chair, Dental Examination Committee

Terms for Current ADEX Board of Directors* District Incumbent Remaining Tenure

District 2 Stan Kanna, DDS 0 Year District 4 Bruce Barrette, DDS 0 Year District 5 M. H. VanderVeen, DDS* 1 Years District 6 Michelle Bedell, DMD* 2 Years District 7 Guy Shampaine, DDS 0 Year District 8 Robert Ray, DMD 1 Years District 9 Peter DeSciscio, DMD 1 Years District 10 Richard Dickinson, DDS 2 Years District 11 Jeffrey Hartsog, DDS* 0 Year District 12 Wade Winker, DDS* 2 Years Consumer Member Ms. Judith Ficks 1 Years Consumer Member Mr. Zeno St. Cyr, II 0 Year Hygiene Member Cathy Turbyne, EdD, MS, RDH 0 Year Hygiene Member James Tuko McKernan, RDH* 1 Years

* members of the Board of Directors are eligible to serve a second three-year term if elected by their district.


ADEX Committees

Dental Examination Committee

One (1) dentist from each Member Board. One (1) Member Board consumer representative 1 Consumer The Chair of the Dental Examination Committee All appointments are nominated by the representatives of the member state dental boards.

Dental Examination Committee Members Scott Houfek, DDS, WY Chair District 2: (CO, HI, NV, OR, WY) Peter Carlesimo, DDS, CO Stan Kanna, DDS, HI William Pappas, DDS, NV Jonna Hongo, DMD, OR TBD, WY Rick Thiriot, DDS, NV Educator District 4: (IA, WI) Gary Roth, DDS, IA Keith Clemence, DDS, WI Leo Huck, DDS, WI Educator

District 5: (IL, IN, MI, OH) Dennis Manning, DDS, IL Matthew Miller, DDS, IN Chuck Marinelli, DDS, MI Eleanore Awadalla, DDS, OH Peter Yaman, DDS, MI, Educator


Dental Examination Committee Members (cont.) District 6: (AK, KY, SC, TN, WV) George Martin, DDS, AR Robert Zena, DDS, KY Michelle Bedell, DDS, SC John M. Douglas, Jr. DDS, TN James Watkins, DDS, VA John Dixon, DDS, WV Rick Archer, DDS, VA Educator Rep

District 7: (MD, PA) Guy Shampaine, DDS, MD Susan Calderbank, DMD, PA Uri Hangorski, PA, Educator District 8: (CT, DC) David Perkins, DMD, CT Rahele Rezai, DMD, DC John Bailey, DDS, DC, Educator District 9: (NH, NJ, RI) Barbara Rich, DMD, NJ Arthur McKibbin, Jr., DMD, NH Henry Levin, DMD, RI Marc Rosenblum, DMD, NJ, Educator District 10: (ME, MA, VT) Robert DeFrancesco, DMD, MA LeeAnn Podruch, DDS, VT Rockwell Davis, DDS, ME Stephen DuLong, DMD, MA, Educator District 11: (AL, LA, MS, NC, PR)

A. Roddy Scarbrough, DMD, MS Larry C. Breeding, DMD, MS, Educator

District 12: (FL) William Kuchenour, DDS, FL Boyd Robinson, DDS, FL, Educator


Dental Examination Committee Members (cont.) Consumer: Alan Horwitz, Esq., PA Testing Specialist: Steven Klein, Ph.D, CA Ex-Officio: Bruce Barrette, DDS, WI ADEX President NERB Administrative Liaison: Nevada Administrative Liaison: Ronald Chenette, DMD, MD Kathleen Kelly, NV SRTA Administrative Liaison: Kathleen White, VA


ADEX Committees (cont.) Dental Hygiene Examination Committee

1 Dental Hygienist from each district 1 Dental Hygiene Educator 1 Dentist 1 Consumer All appointments are nominated by the active member state dental boards.

Dental Hygiene Examination Committee Members

Nancy St. Pierre, RDH, NH Chair

District 2: Jill Mason, RDH, MPH, OR

District 4: Nanette Kosydar Dreves, RDH, MBA, WI

District 5: Lynda Sabat, RDH, OH

District 6: Diana Vaughan, RDH WV

District 7: Marellen Brickley-Raab, RDH, PA

District 8: Judith Neely, RDH, BS, DC

District 9: Shirley Birenz, RDH, BS, NJ

District 10: Karen Dunn, RDH, MA

District 11: Janet Brice McMurphy, RDH, MS

District 12: Irene Stavros, RDH, FL

Dentist: Maxine Feinberg, DDS, NJ

Educator: Donna Homenko, RDH, PhD, OH

Consumer: Zeno St. Cyr II, MPH, MD

NERB Administrative Liaison: Ellis Hall, DDS, MD

NERB Administrative Liaison: Michael Zeder, MD

Testing Specialist: Steven Klein, Ph.D, CA

ADEX President - Ex-Officio, Bruce Barrette, DDS, WI


ADEX Committees (cont.) Budget Committee H. M. Bo Smith, DMD, AR - Chair Scott Houfek, DDS, WY

Neil Hiltunen, DDS, NH Tony Guillen, DDS, NV Guy Shampaine, DDS, MD Charles Ross, DDS, FL Kathleen White, VA Bruce Barrette, DDS, WI - ADEX President Ex-Officio

Bylaws Committee Robert Ray, DDS, WI - Chair Garo Chalian, DDS, CO James Tuko McKernan, NV Alan Horowitz, Esq., PA Bruce Barrette, DDS, WI - ADEX President Ex-Officio

Calibration Committee William Pappas, DDS, NV - Chair Scott Houfek, DDS, WY

Tony Guillen, DDS, NV Rick Thiriot, DDS, NV Neil Hiltunen, DDS, NH Ogden Munroe, DDS, IL Ken Van Meter, DDS, VT Rick Kewlowitz, DDS, FL Wendell Garrett, DDS, AR Ronald Chenette, DMD, MD Richard Marshall, DDS, WV Peter Yaman, DDS, MD

Bruce Barrette, DDS, WI - ADEX President Ex-Officio

Communications Mary Johnston, RDH, MI - Chair Committee Stanwood Kanna, DDS, HI

Kathy Heier, RDH, IL Mary Davidson, RDH, OR Clance LaTurner, IN



Quality Assurance Hal Haering, DDS, AZ - Chair Committee Stanwood Kanna, DDS, HI Patricia Parker, DMD OR Robert Sherman, DDS, HI J. George Kinnard, DDS, NV Barbara Rich, DMD, NJ Nan Kosydar Dreves, RDH, MBA, WI James Haddix, DMD, FL Guy Shampaine, DDS, MD Richard Marshall, DDS, VA Kathleen White, VA Ronald Chenette, DMD, MD Scot Houfek, DDS, WY Nancy St. Pierre, RDH, NH



ADEX Dental Examination Content

Five stand alone examinations - Critical skill sets identified by criticality in the Occupational Analysis

Computerized Examination in Applied Diagnosis and Treatment Planning

Endodontic Clinical Examination

- Manikin-based

Fixed Prosthodontic Clinical Examination - Manikin-based

Restorative Clinical Examination

- Patient-based

Periodontal Clinical Examination - Patient-based

Scoring Criterion based scoring system

Three (3) independent raters without collaboration

Rating Levels

Satisfactory

Minimally Acceptable Marginally Substandard Critically Deficient


ADEX Dental Exam Scoring Criterion-Based Analytical Scoring Rubric:

More detailed feedback. More consistent scoring. Allows for the separate evaluation of factors. Evaluation of all gradable criteria. Scoring methodologies were developed with consultation from the Buros Institute,

University of Nebraska and the Rand Institute with input from studies completed by testing specialists from the University of Chicago.

Three (3) independent raters evaluate all measurable criteria. Median score is utilized when there are no matching scores; all zeros must be

independently corroborated to be utilized as a critical deficiency. Performance criteria-based scoring will be provided to both the candidate and the dental

school so that appropriate remediation can be completed prior to a retake when required. Clinical sections utilize compensatory grading with critical errors within a skill set. No grading across skills. Critical errors are those performance deficiencies that would cause treatment to fail. A

critical error forces a failure on that skill set examination. Not all criteria have critical errors.

Evaluation Criteria

Objective measurable criteria developed by a panel of experts consisting of examiners,

practitioners, and educators.


Amalgam Prep External Outline Criteria (Example) SATISFACTORY

1. Contact is visibly open proximally and gingivally up to 0.5 mm. 2. The proximal gingival point angles may be rounded or sharp. 3. The isthmus must be 1-2 mm wide, but not more than the intercuspal width of the tooth. 4. The external cavosurface margin meets the enamel at 90. There are no gingival bevels. The

gingival floor is flat, smooth and perpendicular to the long axis of the tooth. 5. The outline form includes all carious and non-coalesced fissures, and is smooth, rounded and

flowing. 6. The cavosurface margin terminates in sound natural tooth surface. There is no previous restorative

material, including sealants, at the cavosurface margin. There is no degree of decalcification on the gingival margin.

MINIMALLY ACCEPTABLE

1. Contact is visibly open proximally, and proximal clearance at the height of the contour extends beyond 0.5 mm but not more than 1.5 mm on either one or both proximal walls.

2. The gingival clearance is greater than 0.5 mm but not greater than 2 mm. 3. The isthmus is more than and not more than 1/3 the intercuspal width. 4. The proximal cavosurface margin deviates from 90, but is unlikely to jeopardize the longevity of the

tooth or restoration; this would include small areas of unsupported enamel. MARGINALLY SUBSTANDARD

1. The gingival floor and/or proximal contact is not visually open; or proximal clearance at the height of contour extends beyond 1.5 mm but not more than 2.5 mm on either one or both proximal walls.

2. The gingival clearance is greater than 2 mm but not more than 3 mm. 3. The outline form is inappropriately overextended so that it compromises the remaining marginal

ridge and/or cusp(s). 4. The isthmus is less than 1 mm or greater than 1/3 the intercuspal width. 5. The proximal cavosurface margin deviates from 90 and is likely to jeopardize the longevity of the

tooth or restoration. This would include unsupported enamel and/or excessive bevel(s). 6. The cavosurface margin does not terminate in sound natural tooth structure; or, there is explorer

penetrable decalcification remaining on the cavosurface margin, or the cavosurface margin terminates in previous restorative material. (See glossary under Previous Restorative Material).

7. There is explorer-penetrable decalcification remaining on the gingival floor. 8. Non-coalesced fissure(s) remain which extend to the DEJ and are contiguous with the outline form.

CRITICAL DEFICIENCY

1. The proximal clearance at the height of contour extends beyond 3 mm on either one or both proximal walls.

2. The gingival clearance is greater than 3 mm. 3. The isthmus is greater than the intercuspal width. 4. The outline form is overextended so that it compromises, undermines and leaves unsupported the

remaining marginal ridge to the extent that the pulpal-occlusal wall is unsupported by dentin or the width of the marginal ridge is 1 mm or less.


Endodontic Clinical Examination on a Simulated Patient (Manikin) Part II: Endodontics 18 Scorable Items

Anterior Endodontic Procedures 12 Criteria Access Opening Canal Instrumentation Root Canal Obturation Posterior Access Opening 6 Criteria

Fixed Prosthodontic Examination on a Simulated Patient (Manikin) Part III: Fixed Prosthodontics 43 Scorable Items

Cast Gold Crown 15 Criteria Porcelain-Fused-to-Metal Crown 14 Criteria Ceramic Crown Preparation 14 Criteria Preparations 1 & 2 evaluated as a mandibular posterior 3-unit bridge

Part V: Restorative 47 Scorable Items Class II Amalgam Preparation 16 Criteria Amalgam Finished Restoration 9 Criteria Class III Composite Preparation 12 Criteria Composite Finished Restoration 10 Criteria

Periodontal Clinical Examination

Treatment Selection (Procedural) Patient Selection severity of periodontal disease.

Treatment 1. Subgingival Calculus Detection 2. Subgingival Calculus Removal 3. Plaque/Stain Removal 4. Pocket Depth Measurement 5. Treatment Management


ADEX Dental Post-Exam Analysis Technical Report Developed Demographic Data/Analysis

- Conducted by respective administering agencies - Synopsis of data provided for Restorative and Periodontal Procedures with

several years of history: Demographic Data on the Candidate Pool Failure Rate Summaries Analysis of Candidate Performance by Test Section Analysis of Failure Rates by Group Assignment Analysis of Mean Scores by Procedure/Examination Part Examiners Score Agreement Summary Frequency of Rating Assignments Correlation of Treatment Selection with Restorative Results Frequency of Penalty Assignments

Annual Schools Report - Schools are provided with data regarding their performance annually - Schools are provided individual candidate performance after each examination

series. - School identities are coded so that each school may compare their performance

confidentially - Performance data for each area of examination content is analyzed and

presented - By procedure - By individual criterion

Examiner Profiles - Data is collected for each examiner and compiled into profiles providing

information to the examiners regarding their evaluations. Summary of Total Number of Evaluations per Dental Examiner Summary of Examiner Agreements for each Examination/Procedure Percentage Rating Level Assigned per Procedure Summary of Examiner Agreements & Disagreements across all Procedures Peer Evaluations

- This information is utilized to monitor examiner performance


TECHNICAL ANALYSIS OF ADEX RESULTS: 2011-2012 Prepared by Stephen Klein, Ph.D. and Roger Bolus, Ph.D.

I. Examination Structure and Rules Passing the ADEX test battery in 2012 was accepted by 47 states as evidence that a candidate seeking licensure to practice dentistry had acquired the knowledge, skills, and abilities that are necessary for providing safe and appropriate care. Candidates also must satisfy specific state educational and other requirements to be licensed. Examination Components, Administration, and Format. The ADEX test battery consists of five separate tests: Diagnostic Skills Examination (DSE), Endodontics, Fixed Prosthodontics, Periodontics, and Restorative. The DSE is a computer based enhanced multiple choice test. Many of its items require candidates to make judgments about clinical conditions based on radiographs, photographs, laboratory data, and working models that are displayed on the candidates computer screen. This one-day test is administered at professional test centers across the country. The other four measures are performance tests that are administered using standardized dental instruments and performed at work stations at accredited dental schools. These work stations correspond to ones typically used in practice. The Endodontics and Fixed Prosthodontics tests involve candidates working on manikins that are specially constructed and standardized for the ADEX. A candidate typically takes one of the four performance tests in the morning and another in the afternoon. The Restorative and Periodontics tests are given on one day and the other two performance tests on another day. Case Acceptance. The Periodontics and Restorative care tests involve live patients who are recruited by the candidates. On the restorative test, two examiners independently review each patient to determine the patients suitability for treatment, that is, that the patient has the necessary oral conditions to be treated, the appropriate diagnosis and treatment plan is in place, and the medical history does not contain any counter indications for treatment. If the first two examiners do not agree about the patients suitability, a third examiner is called to break the tie. The ADEX Technical Manual (which is available on the web) describes each tests operational procedures, specifications, and scoring and decision rules.1 Dental Examiners. The quality of a candidates work on each of the four performance tests is evaluated by three specially trained dentists. They record their judgments on an electronic tablet that is programmed for this purpose. The examiners work independently (e.g., they do not discuss the quality of a candidates performance with the other examiners or the patient). To preserve anonymity and independence, examiners do not see or interact with the candidates and they do not watch the candidate perform the work.

1 Case acceptance on the Periodontics exam is discussed later in this report.


Pass/Fail Rules. Candidates must pass all five tests to receive ADEX certification and they must repeat all the parts and sections of any test they fail. A high score on one performance test or test section cannot offset a low score or failing status on another test. Candidates are allowed to retake the exams they failed during the August through May testing window, but they cannot carry a passing status on a test across windows. They must pass all five tests within a window to pass overall.

If in the judgment of at least two examiners the candidate made a critical error or deficiency on a live patient, the candidate is excused from continuing the test and receives a failing grade on it. If that happens, the condition of the candidates patient is temporized and where appropriate, patients are counseled to have any problems with their oral condition addressed by a licensed professional. Analysis Sample and Testing Window. Except as noted otherwise, results are based on the roughly 1,548 candidates who took all five tests with the Curriculum Integrated Format (CIF) for the first time between August 1, 2011 and May 31, 2012.2 Results are based on examinations administered by NERB and the Nevada State Board of Dental Examiners.

II. Pass/Fail Decisions This report focuses mainly on pass/fail decisions (rather than scores) because (1) all the tests were designed to make that type of decision and (2) candidates had to pass each exam to pass overall.

Table 1-A shows the percentage of candidates passing each test on their first attempt and by their last attempt (i.e., if they failed initially and took the exam again). For example, 96.8% passed the DSE on their first try and 98.8% passed after taking this test at least one more time. Most but not all of those failing an exam elected to repeat it.

Table 1-A Number of Candidates Taking Each Test and Percent Passing

Test % Pass on 1st Attempt

% Pass by last Attempt

% Did Not Repeat after Initial Fail

DSE 96.8 98.8 1.0 Endodontics 96.8 99.9 0.1 Fixed Prosthodontics 94.1 99.9 0.0 Periodontics 96.9 99.6 0.2 Restorative Dentistry 86.8 97.7 0.5 Mean 94.3 99.2 0.4

On the Restorative exam, all candidates had to perform an anterior composite restoration and a posterior restoration. However, for the posterior restoration, they could choose to do an amalgam, a box composite, or a conventional restoration. Candidates were classified as having chosen an option if they had a non-zero score or a critical error or deficiency

2 Ns vary slightly across analyses as a result of merging of diverse data sets.


associated with that option. The 27 candidates (1.8% of the total) who did not perform any type of posterior restoration were assumed to have taken and failed the anterior composite and therefore were not allowed to continue (see Table 1-B).

Table 1-B Number of Candidates Taking and Percent Passing Each Restorative Option

Restorative Test Options Number of Candidates % Pass

Anterior Test Only 27 0.0 Anterior w. Amalgam 922 88.1 Anterior w. Box Composite 251 90.8 Anterior w. Conventional Composite 340 88.8

The small differences in passing rates among the three restorative options may stem from inherent differences in the difficulty of these procedures, differences in grading standards among the options, differences in the skills of the applicants who select one option over another, chance, or some combination of these and other factors. The restorative exam had the most influence on a candidate's overall pass/fail status because for most applicants, it was the most difficult one to pass. This was true regardless of which option they selected. Slightly over 75% of the candidates passed the entire exam (all five tests) on their first attempt and 96% passed after repeating one or more tests. Thus, 4% did not pass despite having the option of retaking the exam. Table 2 shows the median (50th percentile) score on each test. Medians (rather than means) are reported because the zeros assigned to critical errors and deficiencies skew the score distributions.

Table 2 Median Scores by Exam for First Timers

Test Median DSE 86.0 Endodontics 98.0 Fixed Prosthodontics 95.0 Periodontics 100.0 Restorative 96.0

Examiners may classify a portion of a procedure within a section (such as proper placement of the access opening) as critically deficient (DEF) or they may indicate a critical error for the section as a whole, such as saying the candidate treated the wrong tooth or tooth surface. If two or more examiners agree the candidate made a particular type of critical error or DEF, then such corroboration results in the candidate failing the exam.


Table 3 shows that with the exception of the Periodontics exam, only a very small percentage of first timers failed a test without having a critical deficiency or committing at least one corroborated critical error (i.e., few failed because of a low point total). And, no one with even an uncorroborated DEF or critical error passed the Endodontics or fixed Prosthodonitics exam.

Table 3

Role of Critical Errors and Deficiencies in Pass/Fail Decisions

Fail with Critical Error Fail without Critical Error Test N % N % Endodontics 46 3.0 3 0.2 Fixed Prosthodontics 90 5.8 1 0.1 Periodontics 13 0.8 35 2.3 Restorative 179 11.6 19 1.2

Table 4 shows that because of the very high passing rates on all the tests, there was little or no correspondence in their pass/fail decisions other than what would occur by chance. For example, the chance agreement rate was usually less than one percentage point lower than the actual agreement rate.3 This finding supports the policy of requiring that applicants pass all five tests in the ADEX battery in order to pass overall.

Table 4

Actual and Chance Agreement in Pass/Fail Decisions Between Examinations

Test Combination

Actual Agreement

Rate

Chance Agreement

Rate

Difference in Agreement

Rates DSE & Endodontics 94.0 93.8 0.2 DSE & Prosthodontics 92.1 91.3 0.8 DSE & Periodontics 94.2 93.9 0.3 DSE & Restorative 85.7 84.4 1.3 Endodontics & Prosthodontics 91.9 91.3 0.6 Endodontics & Periodontics 94.1 93.9 0.2 Endodontics & Restorative 85.0 84.4 0.6 Prosthodontics & Periodontics 91.4 91.4 0.0 Prosthodontics & Restorative 82.3 82.5 -0.2 Periodontics & Restorative 85.2 84.5 0.7 Average 89.6 89.1 0.5

3 The chance agreement rate between two tests is the product of their passing rates plus the product of their failure rates. For example, if the passing rates on the Endodontics and Prosthodontics exams were 95.5 and 94.5%; then their chance agreement rate would be [(.955 x .945) + (.045 x .055)] = 90.5%.


Table 5 shows the reliability (coefficient alpha) of the scores on each test. These values indicate that the very low correlations between tests were not due to score reliability problems. In addition, as a result of the combination of very high pass rates and adequate score reliabilities, an applicants pass/fail status is unlikely to change simply by chance (i.e., as distinct from being better prepared).4 This is referred to as decision consistency in the psychometric literature. Analyses were based on the candidates who took all four performance tests and the DSE.

Table 5 Number of Items per Test and Internal Consistency Reliability

Test

Number Of Items

Number of Candidates Reliability

Endodontics 24 1,522 0.505 Periodontics 37 1,536 0.627 Prosthodontics 43 1,527 0.826 Restorative w. amalgam 54 833 0.655 Restorative w. box 54 234 0.653 Restorative w. conventional 56 308 0.690

III. Inter-Examiner Agreement Endodontic, Prosthodontic, and Restorative exams. As noted in Table 3, failing one of these tests was driven mainly by whether or not the candidate committed a critical error or deficiency. Almost no one failed without committing a corroborated critical error or deficiency; and no one passed who did. A candidate also can fail a test by not earning enough points (the so-called paper grade) but that almost never occurred except on the Periodonticsl test where it was usually the sole determiner of a candidates pass/fail status. The foregoing considerations led us to look at inter-examiner agreement in two ways on the Endodontic, Prosthodontic, and Restorative exams. The first method involved constructing four ratios that focused on the extent to which the examiners agreed the candidate did or did not commit any of the tests possible critical errors or DEFs. For example, there were 21 different types of DEF or critical errors that could be called on the Endodontics test. All four ratios had the same denominator, namely: the number of candidates times the number of possible DEF or critical errors that could be called. The numerator for the first ratio was the total number of patients where all three examiners said there were no DEF or a critical error calls times the number of opportunities for such a call. The numerator for the second ratio was the number of patients where only two of the examiners said there were no DEF or critical error calls times the number of opportunities for making such a call, and so on.

4 Klein, S., Buckendahl, C., Mehrens, W., & Sackett, P. (2009). Evaluating clinical licensing exams for dentists and dental hygienists. American Board of Dental Examiners. Chicago, IL.


Table 6 shows the examiners achieved consensus 98 to 99 percent of the time. This extremely high rate of decision consistency was due in part to the examiners rarely encountering work that they felt deserved being classified as a critical error or DEF (which is not surprising since almost all the candidates completed dental school). The rates also were inflated due to counting all the DEF and critical error calls that theoretically could be called but were hardly ever made.

Table 6 Percent Agreeing Critical Errors Were or Were Not Present

No Critical Error With Critical Error Test % 3/3 % 2/3 % 3/3 % 2/3 Endodontics 99.5 0.4 0.1 0.1

Fixed Prosthodontics 98.6 1.2 0.0 0.2

Restorative w. amalgam 97.8 1.7 0.1 0.3

Restorative w. box 98.7 1.1 0.0 0.2

Restorative w. conventional 97.8 1.9 0.0 0.3 Note: The percentages in a row may not sum to 100.0% due to rounding. The other way we measured examiner agreement involved calculating how often the three examiners made the same overall decision about a candidates pass/fail status based on that candidates paper grade which is a function of the number of points the candidate receives and where a score of 75% or higher of the possible maximum score is needed for passing (see Tables 7-A and 7-B). For example, the last row of Table 7-B shows that all three examiners agreed that of the candidates they saw who did a posterior conventional box prep restoration, 58.3% should pass and 8.2% should fail, for an overall perfect agreement rate of 66.5%. In contrast, the perfect agreement rate that was expected to occur by chance was only 48.4%. Table 7-A

Inter-Examiner Agreement Rates on Endodontics and Prosthodontics

Agree Pass Agree Fail Total % Chance % Test % 3/3 % 2/3 % 3/3 % 2/3 Agree Agree

Endodondtics 91.3 5.6 2.0 1.0 93.4 87.6

Prosthodondtics 72.9 19.1 2.6 5.3 75.5 77.2

Table 7-B Inter-Examiner Agreement Rates on Restorative Test Options

Restorative Test Agree Pass Agree Fail Total % Chance % with Posterior: % 3/3 % 2/3 % 3/3 % 2/3 Agree Agree

Amalgam 58.2 26.3 9.2 6.3 67.4 47.3

Box 65.9 23.3 6.4 4.4 72.3 56.8

Conventional 58.3 27.2 8.2 6.3 66.5 48.4


It is not clear why the actual degree of agreement between two Prosthodontic examiners (75.5%) was slightly (but not statistically significantly) lower than the chance rate (77.2%). This result came as a surprise since manikins rather than live patients are used for this test. Thus, the lower than expected agreement rate cannot be attributable to variation in patient characteristics. This finding suggests a more in-depth investigation is warranted for this test. Periodontics. Case acceptance decisions on this test were done sequentially. In stage 1, the floor examiner classified a patient as acceptable (i.e., satisfied the case qualification criteria) or not. If acceptable the candidate could begin the calculus detection and removal portions of the exam. If the floor examiner determined the patient was not acceptable, then a second examiner evaluated the patient and classified that patient as acceptable or not. If the second examiner said the patient was acceptable, the candidate was cleared for the next portion of the exam. If the second examiner said the patient was not acceptable, the candidate could offer another patient or repeat the exam on another occasion. There were 17 candidates who were flagged for possible penalty point deductions related to Periodontics case acceptance. The floor examiner flagged two candidates for 30-point deductions, but neither deduction was corroborated by another examiner. The first examiner gave two candidates a 20-point penalty, but only one of those cases was corroborated by a second examiner. The first examiner flagged 13 cases for 5-point penalties, but only 9 of them were corroborated by a second examiner. Thus, all told, only 10 of the 17 candidates that were flagged (59%) actually received penalty point deductions. On the Periodontics exam itself, two examiners arrived at the same overall pass/fail decision (based on the paper grade) for about 89% of the candidates. However, because this exams overall pass rate was so high, the 89% figure is only 2 percentage points greater than what would be expected to occur by chance (such as by simply passing 9 out of every 10 of the candidates they evaluated).

IV. Psychometric Properties of the DSE

The DSE has the following three sections: DOR (Diagnosis, Oral Medicine, and Radioloogy), CTP (Comprehensive Treatment Planning), and PPMC (Periodontics, Prosthosdontics, and Medical Considerations). Responses to the DSE are scored by computer. Examiner judgment is not required. Table 8 provides summary data on each part of the DSE and the total score. The internal consistency (score reliability) estimates for the DSE were probably dampened by the restricted score range as indicated by the high mean and median scores. Ideally, reliability coefficients should be about 0.90 for this type of test.


Table 8

DSE Statistical Characteristics

Subtest

Number of Items

Mean percent correct

Standard Deviation

Internal Consistency

CTP 80 85.3 5.3 .511 DOR 100 85.5 6.4 .735 PPMC 100 85.7 5.4 .624 Total 280 85.5 4.8 .828

The moderate observed correlations among the three sections (see Table 9) support the policy of having a pass/fail rule for the DSE that allows for some but not total compensatory scoring; i.e., it is appropriate to assign penalty points if the score on one or two of its sections is especially low. The last column of Table 9 shows what the correlations among the sections are likely to be if they were all perfectly reliable (this is called a correction for attenuation).

Table 9

Observed and Corrected Correlations Between DSE Subtests

Subtests Observed

Correlation Corrected

Correlation CTP with DOR .589 .961 CTP with PPMC .524 .928 DOR with PPMC .494 .729

We continue to recommend that ADEX monitor whether p-values (percent correct) on repeated items are climbing (which could occur if there was a breach in test security) and explore whether pass/fail decisions can be based on equated rather than raw scores.


STATISTICAL ANALYSIS OF THE 2012 DENTAL HYGIENE EXAM

Stephen Klein, Ph.D. and Roger Bolus, Ph.D. October 24, 2012

This report provides summary results on ADEXs Clinical Hygiene Examination and on its Computer Simulated Clinical Examination (CSCE) for dental hygienists. Results are for the 2,124 candidates who took both tests for the first time between April and August 2012. A total score of 75 or higher is needed for passing each test. The percent passing the clinical exam, the CSCE, and both tests on the first try were: 93.5, 93.1 and 87.2 percent, respectively. Clinical Exam Scoring Rules Table 1 shows the number of points candidates could receive on each part of the clinical exam. A candidates score on a part is the median of the scores assigned by three independent examiners. The first two scores are for the Pre-treatment portion of the exam and the last three are for the Post-treatment portion. The total score is the sum of the five part scores minus any penalty points. Appendix A describes the point deductions that could be assigned.

Table 1

Possible Points In Each Section

Number of Points per Total Section judgments judgment Points Pocket Depth Measurement

12 1.5 18

Calculus Detection 12 3.0 36 Calculus Removal 12 3.0 36 Plaque/Stain Removal 6 1.0 6 Hard/Soft Tissue 2 2.0 4 Total 100


Table 2 shows the mean score and standard deviation on each part. A comparison of these means with the corresponding maximum possible scores indicates that most candidates had perfect or near perfect scores on each part. Nevertheless, the reliability (coefficient alpha) of the total score was 0.80, which is high given that (a) candidates may have had different examiners for the pre- and post-treatment sections and (b) there was a significant restriction in the range of scores assigned.

Table 2

Summary Test Statistics by Performance Test Section

Maximum Mean Standard Score Exam Section Score Score Deviation Reliability Pocket Depth Measurement

18 17.54 1.15 .54

Calculus Detection 36 34.77 3.46 .77 Calculus Removal 36 32.94 4.75 .68 Plaque/Stain Removal 6 5.98 0.17 .26 Hard/Soft Tissue 4 3.89 0.31 .01 Total Score 100 93.90 10.50 .80

Penalty points were not included in these calculations. A candidates final score on an item corresponded to the score that at least two of the three examiners assigned. Effect of Penalties Table 3 shows the number and percentage of candidates that lost points for the reasons noted in Appendix A, such as making a pocket depth qualification error. It also shows the number and percent that failed the exam because of these errors; i.e., these candidates would have passed were it not for the penalties they received. The policy of imposing only the largest applicable penalty (rather than the sum of all the separate ones assigned to the candidate) had no effect on the passing rate. No candidate received a deficient (def) score for hard or soft tissue and there were no pocket depth measurement penalties. The mean total clinical score before and after penalty points were awarded were 95.1 and 94.0, respectively.

Table 3 Percentage of Candidates Receiving Penalty Points

Candidates failing All candidates because of penalty Received penalty for: N Percent N Percent Case Acceptance 54 2.5 1 0.0 Pocket Depth Qualification

16 0.8 1 0.0

Calculus Detection 59 2.8 8 0.4 Calculus Removal 76 3.6 72 3.4 Any section 205 9.7 82 3.9


Inter-Examiner Agreement Each candidate's work on the Clinical Examination was evaluated by three independent examiners (i.e., the examiners made their judgments without consultation with each other or knowing the scores assigned by other examiners). Table 4 shows that despite the extreme restriction in range noted in Table 2, there was still an adequate overall correlation between examiners in the scores they assigned.1

Table 4 Mean Correlation Between Two Examiners on Each

Clinical Examination Section and Overall

Exam Section Correlation Pocket Depth Measurement

0.415

Calculus Detection 0.391 Calculus Removal 0.311 Plaque/Stain Removal 0.082 Hard/Soft Tissue 0.100 Total 0.330

Another way to look at examiner agreement is to see how often different examiners would make the same pass/fail decision about an applicant. This analysis (which did not consider penalty points) found that 86.3% of the applicants received a passing grade from all three examiners and 0.6% percent received a failing grade from all three. The total perfect agreement rate was therefore 86.9% (see Table 5). however, an 86.9% agreement rate is only 3.3 percentage points higher than the rate that would occur by chance alone.5

Table 5

Percent Agreement in Overall Pass/Fail Decisions Among the First, Second, and Third Examiners

3/3 Agree Pass

2/3 Agree Pass

3/3 Agree Fail

2/3 Agree Fail

% All

agree

% All Agree by Chance

86.3 10.6 0.6 2.5 86.9 83.6 5 The chance rate is the product of the average of the three examiners individual passing rates. Specifically, the first, second, and third examiners had passing rates of 93.8%, 94.4%, and 94.6%, respectively. The product of these three rates was 83.6%. Analyses were not conducted of the degree to which different examiners and Hygiene Coordinators would make the same decisions regarding case acceptance, the assignment of penalty points, or tooth selection for pocket depth measurements.


Comparison of Clinical and CSCE Statistics Table 6 shows that 87.2% of the candidates passed both tests and 0.6% failed both for an overall agreement rate of 87.8%. However, given the marginal totals, this is very close to the agreement rate that would occur by chance.6

Table 6

Correspondence in the Percentage of Pass/Fail Decisions Between the Clinical and CSCE Exams

Fail Clinical Pass Clinical Total Fail CSCE 0.6 6.3 6.9 Pass CSCE 5.9 87.2 93.1 Total 6.5 93.5 100.0

There was a very low correlation between CSCE and Clinical Examination scores (r = 0.104). If this correlation is corrected for the less than perfect reliability of the measures, it would still be only 0.133. In short, the degree of agreement in pass/fail decisions and scores between these two tests was not much higher than what would occur by chance alone.

Table 7 shows that the very low correlation between the Clinical and CSCE was not the result of their scores being unreliable. They both had adequate reliabilities (coefficient alphas) for making pass/fail decisions, especially given their high passing rates. Taken together, these findings support ADEXs use of a conjunctive rule (i.e., a rule that requires candidates to pass both tests in order to pass overall) rather than a compensatory rule (that would allow candidates to offset a low score on one test with a high score on the other).

Table 7 Summary Test Statistics for the Clinical and CSCE Exams

Standard Test Mean Median Deviation Reliability

Clinical 93.9 97.0 10.5 .80

CSCE 85.4 86.0 6.8 .77 Clinical scores are after penalty points were imposed.

6 Data on repeaters were not analyzed for this report.


Appendix A Clinical Exam Penalty Point And Disqualification Rules

Case Acceptance There are five case acceptance criteria, the first four of which are initially evaluated by a single examiner and have 2 to 4 scoring levels. The fifth criterion, Pocket Depth Qualification, is evaluated by three examiners. The five criteria are:

Required Forms (SAT, ACC, SUB, or DEF) Blood Pressure (SAT, ACC, or DEF) Radiographs (SAT, ACC, SUB, or DEF) Teeth Deposit Requirements (SAT or ACC) Pocket Depth Qualification

No penalty points are deducted if the first examiner assigns a SAT to all of the first four of these criteria. However, if the examiner assigns a non-SAT score to one or more of them, then a second examiner is called in to evaluate all four criteria. If the two examiners agree on a non-SAT call, then that call stands. The point deductions for a corroborated ACC, SUB, and DEF call are 5, 15, and 30, respectively. If the two examiners disagree as to the seriousness of a problem, then the penalty for the least serious call is used. For instance, if the first and second examiners made calls of DEF and ACC for Blood Pressure, then the 5-point penalty for the ACC call stands. Pocket Depth Qualification is evaluated by three independent examiners. Candidates select 3 teeth they believe satisfy the requirements. Three examiners independently make their calls as to whether these teeth are satisfactory. There is a 10-point deduction off the candidates total score if two or three examiners agree that the teeth the candidate nominated do not satisfy the requirements; and 20 points are deducted if two or three examiners agree that two or three of the nominated teeth do not satisfy the requirements. Penalty points do not accumulate across the five case acceptance criteria. Only the largest deduction for any of the five criteria is applied. For example, there is a total deduction of 20 points even if a candidate would otherwise lose 10 points for Blood Pressure, 5 points for Radiographs, and 20 points for Pocket Depth Qualification. Other Point Deductions and Disqualifications Candidates lose 3 points for each corroborated calculation detection or removal error, such as by saying a surface is calculus free when two or three examiners say it is not free of calculus. Candidates fail the exam if they make: (a) 4 or more corroborated calculus detection errors, (b) 4 or more corroborated calculus removal errors, or (c) a corroborated hard or soft tissue critical error. Candidates lose 1.5 points for each corroborated pocket depth measurement error and 1 point for each plaque and stain removal error.


For additional info on ADEX contact:

[email protected] (503) 724-1104

mailto:[email protected]

American Board of Dental Examiners, Inc. P.O. Box 8733 Portland, OR 97207-8733 Telephone (503) 724-1104 [email protected] www.adex.org

mailto:[email protected]://www.adex.org/

DENTAL HYGIENE COMMITTEE

MINUTES

November 30, 2012 The Oregon Board of Dentistry (OBD) Dental Hygiene Committee met at the office of the Board on Friday, November 30, 2012. Committee members present: Jill Mason, M.P.H., R.D.H., E.P.P., Chair; Mary Davidson, M.P.H., R.D.H., E.P.P.; Joni D. Young, D.M.D., ODA Representative; and Kristen L. Simmons, R.D.H., M.H.A., ODHA Representative. The staff present included Patrick Braatz, Executive Director; Lori Lindley, Senior Assistant Attorney General; Stephen Prisby, Office Manager and Teresa Haynes, Licensing Manager. Visitors present were Beryl Fletcher, ODA; Lisa J. Rowley, R.D.H., Pacific University; Lynn Ironside, R.D.H., ODHA; Heidi Jo Grubbs, R.D.H., ODHA; Jonalee Potter, R.D.H., Oral Health Outreach; Josette Beach, R.D.H., Portland Community College and Vickie Woodward, R.D.H., ODHA. Board Members Present: Patricia Parker, D.M.D. Ms. Mason called the meeting to order at 1:30 p.m. Ms. Davidson moved and Ms. Simmons seconded that the minutes of the July 20, 2012 Dental Hygiene Committee meeting be approved as presented. All members voted in favor. Mr. Braatz updated the Committee regarding the workgroup meeting held on November 1st with a few of the Program Directors of CODA accredited dental hygiene and dental assisting programs. Based on that workgroup meeting, proposed language was drafted to define Dentist of Record in an academic setting pursuant to ORS 679.020(4)(h). Mr. Braatz emailed the proposed language, For purposes of ORS 679.020(4)(h) the term dentist of record means a dentist that is either currently authorizing treatment for or is treating the patient to the directors and is awaiting their consensus on the wording. The Committee discussed the possibility of updating the Jurisprudence Examination. Mr. Braatz stated that we are aware that the examination needs to be updated but we have not had time to be able to convene a work group. Mr. Braatz stated that updating the Jurisprudence Examination is on the horizon, but the Boards number one priority is resolving the 218 open complaints. Ms. Simmons moved and Ms. Davidson seconded to recommend to the Board that they appoint a task force to review the Jurisprudence Examination for possible revision. All members voted in favor. Mr. Braatz updated the Committee that as of November 29, 2012 there were 313 dental hygienists with an Expanded Practice Permit, and 22 of those hygienists have a collaborative agreement with a dentist. The Committee reviewed and discussed the nitrous oxide permit application. Ms. Mason, Ms. Rawley and Ms. Beach stated that students at their individual programs are confused on completing the application because when they complete the form they are currently not practicing and the application is asking what their protocols are for administering nitrous oxide. Ms. Simmons moved and Ms. Davidson seconded to recommend that the Board review the nitrous oxide permit application for possible revision. All members voted in favor.

The Committee established the 2013 Dental Hygiene Committee Dates as follows: February 1, 2013 June 7, 2013 October 4, 2013 December 6, 2013 There being no further business, the meeting adjourned at 2:01 p.m.

Executive Directors

Report

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Executive Directors Report October 5, 2012 Page 1 of 2

EXECUTIVE DIRECTORS REPORT December 14, 2012 OBD Budget Status Report Attached is the latest budget report for the 2011-2013 Biennium. This report, which is from July 1, 2011 through October 31, 2012, shows revenue of $1,733,866.90 and expenditures of $1,455,657.74. Revenues continue to be on target and the expenditures to date are actually below what was budgeted. I would say the Budget appears to be performing as expected. If Board members have questions on this budget report format, please feel free to ask me. Attachment #1 OBD 2013 - 2015 Governors Recommended Budget Attached please find the 2013 2015 Governors Recommended Budget. The Governor made the following proposed cuts to the OBD Agency Budget Request that we submitted to the Department of Administrative Services. The OBD Agency Bu

oregon board of dentistry · 12/14/2012 · franklin, pediatric dentist; steven e. timm, d.m.d.,...

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